infarction identified within 3 days from the onset of bleeding not related to aneurysm repair. Circulatory failure and severe intracranial hypertension prior to ECI, or within 3 days from bleeding if no ECI, were retrospectively determined. The association between ECI, prior circulatory failure, severe intracranial hypertension and patient outcomes was tested using uniand multivariate analyses. Results Seven-hundred-and-fifty-three patients with aSAH were included. ECI were observed in 40 patients with a prevalence of 5.3% (95% CI; 3.7-6.9%). New ECI lesions developed in-hospital in 70% of cases. Circulatory failure or severe intracranial hypertension was more common in patients with ECI compared to those without ECI (90% vs.11% respectively <0.001). In ECI patients, in-hospital occurrence of circulatory failure or severe intracranial hypertension was observed in 60% of cases, and was significantly associated new in-hospital ECI lesions (71%vs.33% in patients without new in-hospital ECI lesions, P=0.036). ECI was independently associated with WFNS grade (OR=2.
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